Mumps Vaccine Research Articles

#62: Safety of Live Attenuated Vaccines Administered after Pediatric Liver Transplantation

Abstract Background Live attenuated vaccines (LAVs) are currently contraindicated in immunocompromised patients such as solid-organ transplant (SOT) recipients. The guideline published by the Infectious Disease Society of America also cautions that LAVs after SOT are contraindicated. However, several articles have demonstrated that these patients may receive LAVs safely by adhering to a protocol consisting of an evaluation of many immunological parameters. The aim of this study was to evaluate the safety of LAVs, including measles, mumps, rubella, and varicella to liver transplant (LT) recipients under our clinically based immunization protocol for LT recipients. Methods We conducted a retrospective cohort study on the safety of live attenuated vaccines (LAVs) for measles, rubella, varicella, and mumps to LT recipients at the National Center for Child Health and Development from July 2010 to July 2019. Patients who underwent LT at age under 20 years, who visited our outpatient clinic for vaccination were included. Our institutional protocol for vaccination is shown in Table. Patients’ demographics, underlying diseases, administered vaccines, number and date of vaccination, and adverse events were extracted from their medical records. Adverse events occurring within 4 weeks after vaccination were collected and classified into 4 stages based on severity. Results During the study period, there were 1,904 outpatient clinic visits by 361 patients. Of these, multiple vaccines (median: 2, range: 1–7) including inactivated vaccines and LAVs were simultaneously administered during the 1,213 visits (64%). LAVs were administered to 422 times (209 patients) who met the criteria and included 225 doses of measles and rubella combination vaccine, 224 doses of varicella vaccine, and 215 doses of mumps vaccine. Underlying diseases included cholestatic liver disease (n = 125), followed by metabolic disease (n = 33), acute liver failure (n = 19). Eleven mild adverse events (2.6%) possibly associated with LAVs were reported, but there were no serious adverse events, including vaccine-strain infection, hospitalization, and death. Conclusion LAVs administration for LT recipients were safe without any serious adverse events under our relatively simplistic institutional protocol. However, further research is needed to closely monitor the efficacy and safety of LAVs to LT recipients.

Gelatin-Containing Vaccines for Varicella, Zoster, Measles, Mumps, and Rubella Induce Basophil Activation in Patients with Alpha-Gal Syndrome

Background: The alpha-gal syndrome (AGS) describes a new type I allergy entity to the carbohydrate epitope galactose-α-1,3-galactose (alpha-gal), which is mainly found in mammalian food products (e.g., beef, pork, and venison). Apart from meat products, alpha-gal can also be found in products containing gelatin of bovine or porcine origin. Recent case reports pointed to severe anaphylaxis in patients suffering from AGS after vaccination with vaccines containing hydrolyzed gelatin. It was the objective of this study to evaluate if basophil activation tests (BATs) performed with such vaccines were positive in patients with AGS. Methods: BAT was performed with different dilutions of a gelatin-containing measles, mumps, and rubella (MMR) live vaccine; an attenuated varicella (V) vaccine; an attenuated V-zoster (VZ) vaccine; a MMR live vaccine not containing gelatin (non-gelatin MMR vaccine) in 2 patients with confirmed AGS, 2 patients highly suspicious for AGS, and 2 healthy individuals without any previous medical history for allergies. Results: All patients showed strongly positive results for all gelatin-containing vaccines (MMR vaccine, V vaccine, and VZ vaccine). Non-gelatin MMR vaccine was negative. The 2 healthy controls did not show any basophil activation. Conclusions: Gelatin-containing vaccines should be administered with caution or avoided in patients with AGS because of their high potential to activate basophils indicating a risk for anaphylaxis. Also, BAT is a useful additional tool when it comes to screening for potentially high-risk alpha-gal-containing drugs.

Cross-neutralization between vaccine and circulating wild-type mumps viruses in Korea

Mumps is a contagious disease caused by the mumps virus. It can be prevented using mumps vaccines, administered as a measles-mumps-rubella (MMR) vaccine. For first and second dose immunization, children aged 12–15 months and 4–6 years have been administered this vaccine since 1997 in Korea. Nevertheless, mumps outbreaks still occur in vaccinated populations worldwide. Hence, immunity against these diseases may be attenuated, or there are antigenic differences between currently available vaccine strains and circulating wild-type viruses. After the introduction of national immunization programs in Korea, mumps cases became sporadic. Viral genotypes F, H, and I have emerged since 1998 whereas the vaccine strains belong to genotype A. Here, we compared the amino acid sequences of the haemagglutinin-neuraminidase (HN) gene from wild-type viruses and the mumps vaccine and measured the cross-neutralization titers between them. We selected the F, H, and I wild-type mumps strains circulating in Korea from 1998 to 2016 and analyzed changes in the amino acid sequence of the protein encoded by the HN gene. We measured mumps virus-specific IgG and rapid focus reduction neutralization test (FRNT) titers in Korean isolates and sera obtained from 50 children aged 1–2 years who had been administered a single dose of MMR vaccine. Analysis of the HN protein sequences disclosed no changes in the glycosylation sites but did reveal 4–5 differences between the Korean isolates and the genotype A vaccine strain in terms of the neutralizing epitope sites on their HN proteins. Post-vaccination FRNT titers were significantly lower against genotypes F, H, and I than they were against genotype A. This finding highlights the possibility of a recurrence of mumps outbreaks in vaccinated populations depending on the degree of genetic conservation of the HN gene. Further research into this issue is needed to prevent the resurgence of mumps.

Detection of Mumps Virus of Genotype G in Bangladeshi Children Suffering from Encephalitis

Although mumps virus (MuVi) is an important agent of encephalitis, however, mumps vaccine has not yet been included in the national immunization programme of Bangladesh. Furthermore, the genotype distribution of this virus in Bangladesh is unknown. Cerebrospinal fluid samples collected from 97 children with encephalitis from April 2009 to March 2010 were subjected to polymerase chain reaction (PCR) test to determine the causative agents. MuVi was detected in two samples, these samples were further subjected to conventional PCR using specific primers, then amplicons were sequenced, and genotype was determined as genotype G. Phylogenetic analysis showed that these strains were clustered with strains from Nepal, India, the UK, Thailand, and the USA. By Bayesian inference, we also determined that the ancestor of Bangladeshi and Indian MuVi were same and segregated only about two decades back. These results will help future surveillance and the detection of invading MuVi strains from other countries.

The Immunogenicity and Safety Profile for KM-248, a Combined Measles, Mumps, and Rubella Vaccine, and Its Noninferiority to the Measles Vaccine in Healthy Japanese Children: a Phase 3 Randomized Multicenter Single-Blind Clinical Trial

The domestic combined measles-mumps-rubella (MMR) vaccine was withdrawn in Japan in 1993 following an outbreak of aseptic meningitis attributed to the mumps component of the cocktail. KM-248 is an MMR vaccine (M-M-R®II), manufactured by Merck & Co., Inc. (Kenilworth, NJ, USA) and registered and approved in 74 countries, but which has not been approved in Japan. This multicenter, randomized, single-blind study, was designed to evaluate the noninferiority of the KM-248 measles component in terms of immunogenicity when compared to the control measles vaccine already approved in Japan and the seroconversion rates for these three viruses following KM-248 administration. Vaccination with KM-248 in children aged 12-90 months (n = 178) induced robust immune responses to measles, mumps, and rubella viruses. The seroconversion rate for the measles virus by the measles component of KM-248 (n = 172) was shown to be non-inferior to that of the control measles vaccine (n = 85). No serious adverse reactions, such as aseptic meningitis or anaphylaxis, were observed. Fever is one of the most common adverse reactions associated with vaccination and was observed in approximately half of the participants. KM-248 administered to healthy Japanese children aged between 12 and 90 months demonstrated a comparable safety and efficacy profile to the control vaccine.

An updated review of the epidemiological factors associated with recurrent respiratory papillomatosis.

ObjectivesTo identify studies evaluating the epidemiology of recurrent respiratory papillomatosis (RRP), including patient demographics, human papillomavirus (HPV) immunology, clinical course, surgical and medical treatments, and psychosocial factors.MethodsA systematic literature search through PubMed was performed to identify studies evaluating the epidemiological factors associated with RRP. All studies were screened through a priori selection criteria using the titles and abstracts.ResultsA total of 208 studies were identified, of which 54 met eligibility criteria and were included in the review.ConclusionsRRP is a rare disease most commonly caused by HPV 6 and 11. It is characterized by recurring benign papillomatous lesions in the respiratory tract, particularly the larynx. Existing evidence about disease risk factors is limited but includes both maternal HPV infection and patient smoking and sexual behaviors. Disease management involves a combination of routine surgical and medical treatment. Surgical techniques include CO2‐laser, sharp dissection, coblation, microdebridement, and photoangiolytic laser. Medical treatments which have been found to facilitate disease control off‐label include interferon‐alpha (IFN‐α), indole‐3‐carbinol, acyclovir, bevacizumab, retinoids, and the Gardasil and mumps vaccines. Many patients suffer from additional psychosocial challenges related to their diagnosis. Current disease knowledge remains limited, and more robust controlled trials about risk factors, medical therapies, and surgical options are needed.Level of Evidence5.

Determination of ELISA reactive mumps IgG antibodies in MMR vaccine recipients in comparison with MMR vaccine naive children: A cross sectional study

Background/Aim: Mumps is by vaccine preventable infectious disease characterised by parotitis. In India mumps vaccines are not currently used under National Immunisation Programme (NIP). Waning of vaccine-induced immunity is considered to play a central role in the re-emergence of mumps. The comprehensive data on the seroepidemiology of measles, mumps, and rubella (MMR) as well as studies which compare the antibody titre among mumps vaccine naiveand mumps vaccinated children are lacking. The aim of this study was to estimate and compare mumps specific antibody titre in children with and without MMR vaccine. Methods: In 2019/2020, blood samples were collected from 100 healthy children attending immunisation clinic in Government Medical College Kota and associated J K Lon Maternal and Child care hospital Kota. The samples were investigated for MMR IgG antibodies using ELISA. Results: Out of total 100 children included in the study, 32.27 % vaccinated and 4.83 % non-vaccinated children were positive for mumps IgG antibody in the age group of 6 months to 6 years of age. Children aged 6 to 12 years, vaccinated and non-vaccinated, had 31.57 % and 26.57 % positivity, respectively. The seroprevalence of measles, mumps and rubella antibodies among 50 MMR vaccinated children were 94 %, 64 %, and 96 %, respectively. A high measles and rubella seroprevalences were observed among all children age groups, suggesting an effective control program, while the mumps seroprevalence decreased significantly with age. Conclusion: The maximum vaccine effectiveness against mumps for 2 doses of MMR vaccine is ≈ 96 %. The herd immunity threshold to block mumps virus transmission is ≥ 86 %. In this study only 64 % of the vaccinated children were found to have IgG mumps antibodies. In view of morbidity following mumps infection there is a need to incorporate mumps vaccine along with measles and rubella vaccine in the NIP instead of Mr.

Modern features of the epidemic process of viral infections with aerosol transmission in Sumy oblast

Viral infections with aerosol transmission are one of the most common infectious diseases in the world. Their relevance is due to the wide distribution and socio-medical consequences. To study the dynamics of the incidence of viral infections with aerosol transmission in Sumy Oblast, to determine the level of influence of social and natural factors on the intensity of the epidemic process. Data from the sectoral statistical reporting of the Ministry of Health of Ukraine, Sumy Regional Laboratory Center, the Main Department of Statistics in Sumy Oblast, Sumy Regional Center of Hydrometeorology were used. Epidemiological and statistical research methods were used. It was established that in Sumy Oblast the epidemic process of aerosol viral infections was characterized by a pronounced tendency to reduced incidence of influenza (Rinc.aver.= -6.2 %) and rubella (Rinc.aver.= -22.7 %), moderate reduction tendency ‒ to mumps (Rinc.aver = -2.4 %); high intensity with no reduction in incidence ‒ for other acute respiratory diseases (Rinc.aver = 0.2 %); a sharp increase in the incidence of measles (Rinc.aver.= 23.1 %). Coronavirus infection caused by SARS-CoV-2 was found in 3% of the population. The average long-term rates of measles, rubella, and mumps vaccinations with MPR-1 and MPR-2 vaccines were 70.9 % and 61.2 %, respectively. An inverse correlation was established between air humidity, population, coefficients of natural and migratory movement and measles incidence (p<0.05). The system of epidemiological surveillance of infections of viral etiology with aerosol transmission requires new approaches to the development of preventive measures.

Evaluation of the Efficacy of Intralesional Measles, Mumps, and Rubella Vaccine with Intralesional Vitamin D3 as Immunotherapies in the Treatment of Recalcitrant Cutaneous Warts in Adult- A Randomized Placebo-Controlled Study.

Introduction:Currently, various destructive and ablative treatment options are conventionally used for warts, but all of them are limited in some form by their adverse effects, high recurrences, suboptimal effectiveness, and the need to treat every wart. Lately, immunotherapy has emerged as a safe treatment relying on biological substances that modulate the immune system to achieve disease control.Aims and Objectives:We aimed at conducting a placebo-controlled study to compare the rate of efficacy of intralesional MMR vaccine with vitamin D3 in the management of recalcitrant extragenital warts in immune-competent adults. Follow-up was done at third and sixth month.Materials and Methods:Patients were divided into three groups, namely, group A, B, and C. Groups A, B, and C received intralesional MMR vaccine, vitamin D3 and normal saline, respectively, in the largest wart. The injections were repeated every 2 weeks, for a maximum of four injections.Results:Among injected warts, in group A, complete clearance was seen in 29 (87.8%) patients, partial clearance in two (6.1%) and no response in two (6.1%) patients. In group B, 24 (77.4%) patients, five (16.1%) patients, and two (6.5%) patients showed signs of complete, partial, and no clearance, respectively, in injected warts. Complete response in distant warts was seen in 25 (75.7%) patients in group A and 20 (64.5%) patients in group B. There was no statistically significant difference between responses of the two groups. In group C, only three (12.5%) patients had complete clearance in injected warts, and none in distant warts. Recurrence was seen in two (6.4%) patients, each in group B and C. However, for management of verruca plana MMR was found to be superior to vitamin D3.Limitations:Our study was limited by a small sample size, absence of immunological analysis, and limited follow-up period.Conclusion:MMR vaccine and vitamin D3 are equally effective and safe treatment option for multiple, recalcitrant warts, as well as warts on difficult to treat sites with minimal recurrence.

COVID-19. SARS-Cov-2 pandemic, transmission pathways, distribution features, and individual susceptibility

In December 2019, an outbreak of pneumonia of unknown etiology was registered in Wuhan, Hubei province of the people's Republic of China. The virus was soon isolated and its genome sequenced. It is called the severe acute respiratory syndrome coronavirus‑2 (SARS-Cov-2, English SARS-Cov-2), and the disease caused by it is coronavirus infection – 19 (English COVID-19). Who recognized the COVID-19 outbreak as a pandemic on March 11. The entire world is currently affected by the pandemic. The first focus of coronavirus infection in Russia was detected on February 27, brought from Europe. The infection reached the most remote corners of Siberia by mid-April. The aim of this study is to analyze the characteristics of SARS-Cov-2, its pathways into the body and individual susceptibility to the virus. Methods and materials. The review of scientific articles on the research topic was based on the analysis of scientific articles on COVID-19. Articles were searched in the Web of Sciences, Scopus, PubMed, and eLIBRARY databases, as well as by article links. Results. The SARS-Cov-2 virus is a single-stranded positive-chain RNA virus from the Coronavirus family (Coronaviridae). According to most researchers, the SARS-Cov-2 virus evolved from bat coronaviruses, with the approximate time of divergence from the nearest bat virus species RaTG13 occurring in 1963. It uses ACE-2 receptors, which are widely present throughout the body, to enter host cells. High virus contagiousness is provided by the acquisition of an additional furin site for cleavage of the spike protein in the form of the amino acid sequence Arg-Arg-Ala-Arg (682RRAR685). This site of the S1 domain of the spike protein can be cleaved by: transmembrane serine protease 2 (TMPRSS2), furin, but also many cellular and extracellular proteases, as well as plasmin(ogen) s. Many ways of cleavage of the spike protein significantly increase the ability of the virus to enter the cell and its contagiousness. The main routes of transmission of SARS-Cov-2 are respiratory drops and close contact. The main entrance gate of the virus is the respiratory tract, may be conjunctiva, likely fecal-oral pathway. The article discusses the skin as an entrance gate. Some skin manifestations of the disease can be caused by this way. The incubation period of COVID-19 lasts on average 5-6 days, while the live infectious virus begins to be released 2-3 days before the first symptoms appear and stops on the 8th day after the symptoms appear, but only in severe patients the virus release can last up to 15 days. Asymptomatic patients may account for 40% of cases. Features of individual susceptibility to COVID-19 and the severity of clinical manifestations may be caused by: 1) the property of allelic variants of the virus and their virulence; 2) the infectious dose of the virus; 3) the use of protective equipment; 4) individual characteristics of the human body; 5) pathogenic mechanisms of infection development. The hypothesis of the protective role of the mumps vaccine explains the phenomenon of extremely low morbidity, asymptomatic or mild infection in children more convincingly. Mass vaccination against mumps in our country began in 1981 (39 years ago), which is probably why children and people under 40 rarely get a severe form of infection in our country. Conclusion. SARS-Cov-2 has pandemic potential and is estimated to be more severe than pandemic influenza viruses. Active isolation of the virus before the onset of symptoms, including by asymptomatic patients (including children), causes the rapid spread of infection and reduces the effectiveness of anti-epidemic measures. The presence of a significant segment of the population with cross-immunity to SARS-Cov-2, including and as a result of vaccination, it is the most likely cause of a high percentage of asymptomatic and mild forms of the disease among children and young people. Effective protection against coronavirus infection in 2019 can only be achieved by taking comprehensive measures to prevent the virus from entering the body through the respiratory tract, per os, conjunctiva and skin, although the latter pathway is not taken into account anywhere in the world. It should be noted that COVID-19 cannot be classified as a particularly dangerous infection, but its high contagiousness, the likelihood of multiple entry gates of the virus into the human body, multi-organ lesions and a high mortality rate of risk groups make it a special infection that requires significant efforts of humanity to eliminate it.

Safety of LAVs administered after pediatric LT.

Recent guidelines suggest that LAVs may be given to LT recipients meeting certain criteria. However, information is still limited. We sought to evaluate the safety of LAVs, including measles, mumps, rubella, and varicella to LT recipients following our clinically based immunization protocol for LT recipients. We conducted a case-series analysis on safety of LAVs for measles, rubella, varicella, and mumps given to LT recipients at our institution from July 2010 to July 2019. Patients who underwent LT at age <20years who visited our immunization clinic were included. LT recipients were vaccinated if 2years had lapsed from LT, had no signs of rejection within 6months, and were on minimal immunosuppressants. Patient demographics, underlying diseases, type and number of vaccines administered, date of vaccination, and adverse events occurring within 4weeks after vaccination were extracted from their medical records. During the study period, LAVs were administered 422 times to 209 patients who met criteria and included 225 doses of MR combination vaccine, 224 doses of varicella vaccine, and 215 doses of mumps vaccine. Underlying diseases included cholestatic liver diseases (n=125), followed by metabolic diseases (n=33) and acute liver failure (n=19). Nine non-critical adverse events (2.1%) possibly associated with LAVs were reported, but there were no serious adverse events, including hospitalizations or deaths. In conclusion, LAVs administered to LT recipients were safe without any serious adverse events following our relatively simple institutional protocol.

Development of Improved Mumps Vaccine Candidates by Mutating Viral mRNA Cap Methyltransferase Sites in the Large Polymerase Protein.

Although a live attenuated vaccine is available for controlling mumps virus (MuV), mumps still outbreaks frequently worldwide. The attenuated MuV vaccine strain S79 is widely used in mumps vaccination in China, but still with many shortcomings, among which the most prominent are the side effects and decreased immunity. Therefore, there is a need to further improve the safety and efficacy of the current MuV vaccine. In the present study, we further attenuated MuV S79 vaccine strain by inhibiting viral mRNA methyltransferase (MTase). We generated a panel of eight recombinant MuVs (rMuVs) carrying mutations in the MTase catalytic site or S-adenosylmethionine (SAM) binding site in the large (L) polymerase protein. These rMuVs are genetically stable and seven rMuVs are more attenuated in replication in cell culture and five rMuVs are more attenuated in replication in lungs of cotton rats compared with the parental vaccine strain S79. Importantly, cotton rats vaccinated with these seven rMuV mutants produced high levels of serum neutralizing antibodies and were completely protected against challenge with a wild-type MuV strain (genotype F). Therefore, our results demonstrate that alteration in the MTase catalytic site or SAM binding site in MuV L protein improves the safety or the immunogenicity of the MuV vaccine and thus mRNA cap MTase may be an effective target for the development of new vaccine candidates for MuV.Electronic supplementary materialThe online version of this article (10.1007/s12250-020-00326-y) contains supplementary material, which is available to authorized users.

Vaccine sentiments and under-vaccination: Attitudes and behaviour around Measles, Mumps, and Rubella vaccine (MMR) in an Australian cohort

ObjectiveThe study aimed to examine the consistency in factors associated with attitudes towards vaccination and MMR vaccination status. MethodsUsing the nationally representative Longitudinal Study of Australian Children matched with the Australian Childhood Immunisation Register, 4,779 children were included from 2004–2005 to 2010–11. Different MMR vaccine dosages and general attitude towards vaccination were modelled individually with multinomial logit regressions, controlling for demographic, socioeconomic, and health related factors of the children and their primary carers. ResultsThe group with non-vaccination and negative attitudes was characterised by more siblings and older parents; the group with under-vaccination but positive attitudes was characterised by younger parental age; and the group with under-vaccination and neutral attitudes was characterised by less socioeconomically advantaged areas. The presence of parental medical condition(s), being private or public renters, and higher parental education were associated with under-vaccination but not with attitudes towards vaccination, whilst parental religion was associated with attitudes towards vaccination but not reflected in the vaccine uptake. ConclusionsVaccine attitudes were largely consistent with MRR vaccine outcomes. However, there was variation in the associations of factors with vaccine attitudes and uptake. The results have implications for different policy designs that target subgroups with consistent or inconsistent vaccination attitudes and behaviour. Parents with intentional and unintentional under-vaccination are of policy concern and require different policy solutions.

Vaccinomics and Adversomics in the Era of Precision Medicine: A Review Based on HBV, MMR, HPV, and COVID-19 Vaccines.

Precision medicine approaches based on pharmacogenomics are now being successfully implemented to enable physicians to predict more efficient treatments and prevention strategies for a given disease based on the genetic background of the patient. This approach has already been proposed for vaccines, but research is lagging behind the needs of society, and precision medicine is far from being implemented here. While vaccinomics concerns the effectiveness of vaccines, adversomics concerns their side effects. This area has great potential to address public concerns about vaccine safety and to promote increased public confidence, higher vaccination rates, and fewer serious adverse events in genetically predisposed individuals. The aim here is to explore the contemporary scientific literature related to the vaccinomic and adversomic aspects of the three most-controversial vaccines: those against hepatitis B, against measles, mumps, and rubella, and against human Papilloma virus. We provide detailed information on the genes that encode human leukocyte antigen, cytokines and their receptors, and transcription factors and regulators associated with the efficacy and safety of the Hepatitis B and Measles, Mumps and Rubella virus vaccines. We also investigate the future prospects of vaccinomics and adversomics of a COVID-19 vaccine, which might represent the fastest development of a vaccine ever.

Mumps outbreaks across Canada, 2016 to 2018.

An increase in mumps incidence was observed in late 2016 (365 cases in 2016 compared to 59 cases in 2015). This unusual level of mumps activity prompted the Public Health Network Council and the National Advisory Committee on Immunization to request situation awareness updates from the Centre for Immunization and Respiratory Infectious Diseases (CIRID) at the Public Health Agency of Canada in 2017 and 2018. A mumps outbreak survey was developed and administered by epidemiologists within CIRID and sent electronically to provincial and territorial public health officials in charge of mumps surveillance. The survey collected information on mumps outbreaks pertaining to demographics, risk factors, laboratory data and public health interventions. The first survey collected data on outbreaks occurring between January 1, 2016 and February 28, 2017, while the second survey contained outbreak data from January 1, 2017 to July 31, 2018. Duplicate outbreaks entries were removed. The response rate for the first and second surveys was 61% and 69%, respectively. Twenty-four mumps outbreaks across nine provinces were reported between January 1, 2016 and July 31, 2018, for a cumulative total of 881 mumps cases. Adolescents and adults 15 to 39 years of age accounted for the majority of cases (80.6%). Specifically, adults 20 to 24 years of age represented the largest proportion of cases (24.6%). Community and social gatherings were the most common exposure setting (62.5%). Slightly more than one third of cases were known to have received at least two doses of mumps-containing vaccine (35.6%). Results from the surveys indicate that the increase in mumps activity was widespread throughout Canada, affecting multiple jurisdictions. Young adults accounted for the largest proportion of cases. These surveys provided evidence to support recommendations on the use of additional mumps vaccination in outbreak settings.

The estimated impact of decreased childhood vaccination due to COVID-19 using a dynamic transmission model of mumps in Japan

ABSTRACT The exact impact of the decline in childhood vaccination coverage during COVID-19 outbreak has not been estimated for any vaccine-preventable diseases. Our objective was to evaluate the impact of decreased mumps vaccination due to COVID-19 on the disease burden of mumps in Japan. Using a previously validated dynamic transmission model of mumps infection in Japan, the incidence rate of mumps over the next 30 y since July 2020 was estimated. The estimated average incidences were 269.1, 302.0, and 455.4/100,000 person-years in rapid recovery, slow recovery, and permanent decline scenarios. Compared with the rapid recovery scenario, the incremental number of mumps cases, total costs, and QALYs loss over the next 30 y were 6.53 million cases, 2.63 billion USD, and 49,246 for the permanent decline scenario, respectively. In conclusion, the persistent decline of mumps vaccination rate as an impact of COVID-19 causes a significant incremental disease burden of mumps, which is consistent irrespective of the possible decline of transmission rate of mumps infection, unless the rapid recovery of coverage rate is achieved. The immediate measures to advocate the vaccination program is essential to mitigate the incremental disease burden in the COVID-19 period.

Primary immunodeficiency masks: A clinical case of vaccine-associated paralytic poliomyelitis

Human inborn immune-related errors comprise a heterogeneous group of rare genetically determined diseases of the immune system caused by loss or gain of function mutations altering relevant protein functions. The 2019 International Union of Immunological Societies recently proposed the classification for such pathologies now comprising 406 distinct disorders with 430 different gene defects. Predominantly antibody deficiencies represent most common group of human inborn immune-related errors, which diagnostics poses uneasy challenge for general practitioner due to a broad range of their clinical manifestations, such as infection, allergy, autoimmunity and malignancy. In addition, patients with human immune-related inborn errors may develop a vaccine-associated disease after administering live vaccines in accordance with the Russia-wide National Vaccine Schedule. Most common among vaccine-associated diseases are vaccine-associated paralytic poliomyelitis, vaccine-associated encephalitis (1 case per 1 000 000 doses of measles, rubella, varicella vaccine), vaccine-associated meningitis (1 case per 250 000 – 500 000 doses of mumps vaccine) as well as adverse effects related to BCG immunization: local (infiltration, cold abscess – 8.6 case per 100,000 vaccinated patients) and disseminated complications (BCG lymphadenitis – 15.5 case per 100 000 vaccinated patients, BCG osteitis – 3.5 case per 100 000 vaccinated patients). Vaccine-associated paralytic poliomyelitis in vaccinated patients occurs after the first, second and rarely third oral polio vaccine dose inoculation. Incidence rate for vaccineassociated paralytic polio after 1 and 3 oral vaccine inoculation ranges from 1 case per 700 000 vaccine doses to 1 case per 3 500 000, respectively. Vaccine-associated paralytic poliomyelitis mainly emerges due to inborn mutations related to humoral immunity after primary vaccination with oral polio vaccine or close contact of unvaccinated patients with subjects vaccinated with oral polio vaccine. Here, we describe a clinical case of vaccine-associated paralytic poliomyelitis in patient with primary immunodeficiency. Our is aimed at emphasizing importance of immunological alertness with regard to detecting primary immunodeficiencies and timely apply a replacement therapy prior to verifying type of immunodeficiency.

AI takes its best shot: What AI can—and can't—do in the race for a coronavirus vaccine - [Vaccine

IN AN ACHIEVEMENT that would have startled biomedical researchers merely a year ago, vaccines against COVID-19 were already being tested in humans this past March, less than three months after the initial outbreak was identified in China. Many of those vaccines owed their speedy start to the power of artificial intelligence (AI). The feat is a promising and remarkable turn in the 200-year-plus history of immunization. The experience may revolutionize the way vaccines are created, potentially saving countless lives in epidemics yet to come. As of early September, there were 34 vaccine candidates being tested in humans, according to the World Health Organization (WHO). Another 145 candidates were being tested in animals or in the lab, says WHO, which keeps a running worldwide list. Those are astonishing numbers, considering that less than a year ago no one had heard of the novel coronavirus, now known as SARS-CoV-2, which causes the respiratory disease COVID-19. It typically takes many years, or even decades, to develop a vaccine; until now, the speed record was held by the mumps vaccine, which went from a collected sample to a marketed product in about four years.

Mumps Outbreaks in Vaccinated Populations-Is It Time to Re-assess the Clinical Efficacy of Vaccines?

History illustrates the remarkable public health impact of mass vaccination, by dramatically improving life expectancy and reducing the burden of infectious diseases and co-morbidities worldwide. It has been perceived that if an individual adhered to the MMR vaccine schedule that immunity to mumps virus (MuV) would be lifelong. Recent mumps outbreaks in individuals who had received two doses of the Measles Mumps Rubella (MMR) vaccine has challenged the efficacy of the MMR vaccine. However, clinical symptoms, complications, viral shedding and transmission associated with mumps infection has been shown to be reduced in vaccinated individuals, demonstrating a benefit of this vaccine. Therefore, the question of what constitutes a good mumps vaccine and how its impact is assessed in this modern era remains to be addressed. Epidemiology of the individuals most affected by the outbreaks (predominantly young adults) and variance in the circulating MuV genotype have been well-described alluding to a collection of influences such as vaccine hesitancy, heterogeneous vaccine uptake, primary, and/or secondary vaccine failures. This review aims to discuss in detail the interplay of factors thought to be contributing to the current mumps outbreaks seen in highly vaccinated populations. In addition, how mumps diagnoses has progressed and impacted the understanding of mumps infection since a mumps vaccine was first developed, the limitations of current laboratory tests in confirming protection in vaccinated individuals and how vaccine effectiveness is quantified are also considered. By highlighting knowledge gaps within this area, this state-of-the-art review proposes a change of perspective regarding the impact of a vaccine in a highly vaccinated population from a clinical, diagnostic and public perspective, highlighting a need for a paradigm shift on what is considered vaccine immunity.

Opinion of the Pathogenesis of the Mumps Meningites

It is generally accepted that meningeal reactions in patients with mumps are due to the direct involvement of the meninges by the mumps virus. With the development of mumps vaccines, this view was extended to vaccinated people, who are considered serious post-vaccine meningitis. In present article, the author states that these reactions are not due to inflammation of the meninges, but to the choroid plexus caused by virulent and vaccine strains. Inflammation leads to an increase in cerebrospinal fluid secretion, which increases intracranial pressure and is manifested by meningeal symptoms. In the presence of this evidence, the author considers that meningeal reactions are not meningitis, but meningisms, based on clinical data, experiments on monkeys and the glymphatic system.